Fluoride and your patient: how to start the conversation

DATE: August 2020
AUTHOR: Louise Sinclair

For patients at risk for dental caries, fluoride therapy is a key preventive tool. However, fluoride is not always an easy topic to broach with our patients. Here, we discuss the reasons dental hygienists might encounter resistance from patients, along with strategies for communicating the benefits of fluoride therapy.

Why some patients reject fluoride

In recent years, a growing anti-fluoride movement has questioned the proven safety and efficacy of fluoride, leading to much misinformation in the mainstream media. As such, we sometimes encounter patients who feel anxious or skeptical about fluoride therapy.

Some patients show poor overall compliance with, or active resistance to, therapies in general. Why do I need this? Can I afford this? Is this really good for me? Why didn’t my last RDH recommend it? Others are simply unaware of the anti-caries and other benefits of fluoride.

A key role for dental hygienists

As dental hygienists, we’re well-placed to start a conversation about fluoride, address our patients’ concerns or knowledge gaps, and provide in-office and home-use fluorides that suit their needs. These may include in-office therapies like Colgate® PreviDent® Varnish, which contains 5% sodium fluoride, and at-home prescription fluoride pastes like Colgate PreviDent® 5000ppm Booster Plus, which contains 1.1% sodium fluoride.

Starting the conversation about fluoride therapy

1. Educate patients about dental caries
Patients tend to be more receptive to our recommendations when they understand why we’re making them. When you identify that your patient is at risk for dental caries, explain what this means for them before introducing the topic of fluoride. Explain that dental caries (tooth decay) is a progressive disease, why it occurs, how it begins with loss of minerals weakening the tooth and how it typically progresses until there is a cavity.

2. Communicate the benefits of fluoride
Now that the patient understands the implications of being at risk for dental caries, we can focus on the solution. Reassure patients that fluoride therapies can strengthen teeth, preventing cavities. We can then also explain that they support the remineralization of teeth by helping to put minerals back in the teeth, and can stop further demineralization (loss of minerals). We can summarize by letting patients know that fluorides effectively prevent, reverse and stop dental caries.

3. Present evidence supporting fluoride use
Point out that fluoride is recommended for caries prevention by dental authorities worldwide, including the United States, and be prepared to support the benefits with evidence-based research. Examples include recommendations from the American Dental Association (ADA) Council on Scientific Affairs showing that topical fluoride is safe and effective in preventing dental caries.

4. Acknowledge concerns
If your patient expresses concerns about fluoride safety, be careful to avoid dismissive statements like: “There’s nothing to worry about!” Instead, acknowledge that the conflicting information around fluoride can be worrying and confusing. Assure your patient that you’ve taken the time to review the evidence and you’re confident that fluoride is safe and effective. Be prepared to address common, specific concerns like the risk of fluorosis in children, and have evidence ready to support your assertions.

5. Provide fluoride pastes in the office
Have a supply of prescription-level home fluorides like Colgate PreviDent® 5000ppm Booster Plus in the office to dispense as needed, rather than sending your patient away with a prescription. Not only does this save the patient time and effort, but it also increases the likelihood of them complying with your recommendations. And for the office, there’s the benefit of additional revenue derived from needed in-office treatment and offering patients convenience by dispensing products.